Provider Demographics
NPI:1174509038
Name:WOLF, MARIA (RN)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:777 ALGOMA BLVD
Mailing Address - Street 2:RADFORD HALL
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-3534
Mailing Address - Country:US
Mailing Address - Phone:920-424-2424
Mailing Address - Fax:920-424-1769
Practice Address - Street 1:777 ALGOMA BLVD
Practice Address - Street 2:RADFORD HALL
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-3534
Practice Address - Country:US
Practice Address - Phone:920-424-2424
Practice Address - Fax:920-424-1769
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41188200Medicaid